硬化剂加生物蛋白胶治疗Forrest Ⅰa,Ⅱa级上消化道出血

目的 了解硬化剂加生物蛋白胶治疗ForrestⅠa ,Ⅱa级上消化道出血的疗效。方法 治疗组采用内镜直视下将针式导管自活检孔道送至病灶处 ,在血管周围分四点注射 5 %鱼肝油酸钠 ,然后将专用双腔导管通过胃镜活检孔把溶解好的医用生物蛋白胶喷洒在出血灶的面及其周围。对照组 :采用内镜下单纯注射5 %鱼肝油酸钠 ,方法同前 ,术后禁食 3～ 5d。两组在治疗期间 ,常规使用质子泵抑制剂 ,密切观察腹部体征及有无出血。结果 治疗组止血率达 10 0 .0 % ,近期再出血率 10 .7% ,2例行手术治疗 ,术后病检证实为胃底的平滑肌瘤和胃角的早期腺癌凸对照组止血率达 87.5 % ,近期再出血率 2 8.5 % ,出血 4例再行硬化剂治疗 ,仍有 2例再发出血转外科手术治疗 ,有 1例病检证实为胃癌。结论 硬化剂加生物蛋白胶治疗ForrestⅠa ,Ⅱa级上消化道出血的疗效肯定 ,止血率高 ,再出血率低 ,且无明显毒副作用 ,值得推广使用。

Traditional Chinese Medicine Diagnosis and Evaluation of the Clinical Effect in Post-hepatitic Cirrhosis based on Fuzzy Analysis

In view of the problem of traditional Chinese medicine (TCM) diagnosis, fuzzy comprehensive evaluation is introduced to the diagnosis and evaluation of the clinical effect of hepatitis. A new diagnosis and evaluation model of the TCM clinical effect standard was presented. The old disputed evaluation model by subjective analysis can be displaced by this objective method in its evaluation system. The foundation of this method is the fuzzy diagnosis model. This method has been realized to diagnose hepatitis and its values in practice has been validated through examples of clinical syndromes of post-hepatitic cirrhosis.